The Use of a Computer Program to Help Primary Care Providers Treat Patients With Type 2 Diabetes

The Use of a Computer Assisted Diabetes Decision Support (CADS) System to Improve Outcomes in Patients With Type 2 Diabetes Who Are Treated by Primary Care Providers

The primary purpose of this study is to determine whether the use of CADS by primary care providers (PCPs) for their patients with type 2 diabetes (T2DM) changes the quality of care relative to a "usual care" group in terms of objective outcome measures of glycemic control (e.g., A1c, mean blood glucose, frequency of hypoglycemic episodes) and in terms of subjective ratings by patients.

The CADS software integrates the patient's home blood glucose data with appropriate laboratory data (e.g. A1c, liver function, kidney function), demographic data (age, gender), current and previous medications, and active/inactive medical diagnoses. The software makes a recommendation about what medication changes are appropriate with potential alternates. Providers with their patients are block randomized into CADS or "Usual Care" for 1 year.

Inclusion Criteria:

• Non-specialist physician (general internist or family practitioner), nurse practitioner, physicians assistant
• Absence of orders for deployment or permanent change of station
• Willingness to recruit up to 19 patients prior to randomization
• Willingness to deliver "usual care" as defined in Section 6.3.2 of the protocol.

Exclusion Criteria:

• Specialist physicians
• Orders for deployment or permanent change of station
• Unwillingness to recruit up to 19 patients prior to randomization
• No prior experience with management of type 2 diabetes in adults
• Unwillingness to deliver "usual care" as defined in Section 6.3.2 of the protocol.